Screening for a Silent Killer

Early detection of colon cancer is the key to saving lives

Excluding skin cancer, colorectal cancer is the third most common cancer among both men and women, but the second most lethal cancer after lung cancer.

Yet a screening colonoscopy performed at the right time and repeated at appropriate intervals may prevent the disease altogether.

"Individuals with a family history of colon or rectal polyps or cancer, underlying breast or ovarian cancer, or a history of bowel disease such as ulcerative colitis are considered high-risk patients," explains Armando Lopez de Victoria, M.D., a gastroenterologist on the medical staff at Memorial Hospital. "They should have an initial colonoscopy at age 40, or when they are 10 years younger than the age at which a family member was diagnosed with colorectal cancer-whichever comes earlier. Those not considered high risk should have a first screening at age 50."
Dr. Lopez says one colonoscopy is enough to predict the chances of colorectal cancer for a decade if no polyps are found.

"Colon and rectal polyps, which are pre-cancerous, can be removed during a colonoscopy," he says. "It takes about seven years for a polyp to grow to become cancerous."

The screening is crucial to prevent colorectal cancer because it is a silent disease. "In the early stages, colorectal cancer can be effectively treated," Dr. Lopez says. "However, there are no symptoms, so you cannot know if the disease is there without a screening."

Not fun, but simple
Preparation for the colonoscopy is the most difficult part of the test. Patients must clean out their colons completely, using laxatives.

"It's much easier to prepare now than it used to be," Dr. Lopez says. "Now patients need to drink liquids only the day before the exam, use laxatives the night before, and they're done." He adds that most patients remember little or nothing about the examination itself, as it is performed with intravenous sedation.

Watch Out For These Signs

• a persistent change in the bowel habits such as diarrhea, constipation or narrowing of the stool
• bleeding from the rectun or blood in the stool
• unremitting cramping or steady stomach pain
• decreased appetite with weight loss
• weakness and fatigue due to anemia
• jaundice (yellow-green color of the skin and white part of the eye)

"Just because you have these symptoms does not mean you have cancer," Dr. Lopez says. "But you should talk with your doctor to be sure."